Clinics and Practicehttp://clinicsandpractice.org/index.php/cp
<strong>Clinics and Practice</strong> [ISSN 2039-7283] is a peer-reviewed, Open Access, online-only journal that publishes both <em>brief reports</em> and <em>case reports</em> in all areas of clinical medicine. Our journal would welcome any interesting description of patients, procedures and treatment in any condition or disease useful for healthcare professionals.<br /><br />en-USPAGEPress has chosen to apply the <a href="http://creativecommons.org/licenses/by-nc/4.0/" target="_blank">Creative Commons Attribution NonCommercial 4.0 International License</a> (CC BY-NC 4.0) to all manuscripts to be published. <br /><br />An Open Access Publication is one that meets the following two conditions:<br /><br />1. The author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.<br />2. A complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.<br /><br />Authors who publish with this journal agree to the following terms: 1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. 3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.paola.granata@pagepress.org (Paola Granata)tiziano.taccini@pagepress.org (Tiziano Taccini)Mon, 08 Jan 2018 09:26:51 +0100OJS 2.4.8.2http://blogs.law.harvard.edu/tech/rss60Aneurysm treatment response prediction in follow up black blood magnetic resonance imaging. A case series studyhttp://clinicsandpractice.org/index.php/cp/article/view/1047
Black blood magnetic resonance imaging (MRI)is a promising imaging tool in predicting aneurysm rupture. Could it be also valuable in evaluating the treatment effect of endovascular and conservative treated aneurysms? Two patients were treated with stent and coil and one with Aspirine (ASS). Correlation of treatment response and contrast enhancement of the aneurysm wall is examined. In the first case stenting failed to treat the aneurysm and contrast enhancement in the wall did never subside during follow up black blood MRI. In the second case the aneurysm responded well to stenting and decreased in size, which was correlating significantly with attenuation of contrast enhancement in black blood MRI. In the third case the aneurysm responded to ASS treatment by decreasing in size as shown in follow up MR-angiography and the contrast enhancement in its wall decreased after 8 months of therapy. Black blood MRI seems to be a promising tool not only in predicting aneurysms at risk of rupture, but also in observing treatment responses after endovascular procedures or even Aspirine administration. When contrast enhancement decreases, aneurysm treatment seems to be successful as can be shown in decreasing size in the follow up angiography.Athanasios K. Petridis, Marian Suresh, Jan F. Cornelius, Angelo Tortora, Hans Jakob Steiger, Bernd Turowski, Rebecca May
Copyright (c) 2018 Athanasios K. Petridis, Marian Suresh, Jan F. Cornelius, Angelo Tortora, Hans Jakob Steiger, Bernd Turowski, Rebecca May
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http://clinicsandpractice.org/index.php/cp/article/view/1047Tue, 06 Mar 2018 10:55:38 +0100Accidental local infiltration of formalin into the buccal mucosa: A case report and review of the literaturehttp://clinicsandpractice.org/index.php/cp/article/view/1040
Formalin is a hazardous chemical, yet it is the choice of fixative for diagnostic pathology. Dental surgeons routinely use formalin for preservation of oral biopsy specimens. Literature search revealed that during regular biopsy procedures, unintentional injection with formalin has occurred, and such rare seven cases have been reported till date. In addition to the literature review, the present article describes first case of accidental local infiltration with formalin into the buccal mucosa during a biopsy procedure, its damaging effect on the oral tissues, subsequent judicious management of the patient and successful tissue reconstruction with collagen membrane.Sachin C. Sarode, Gargi S. Sarode, Yashwant Ingale, Manjusha Ingale, Mahesh Chavan, Nilesh Patil, Barnali Majumdar, Prashant Kumar, Shankargouda Patil
Copyright (c) 2018 Sachin C. Sarode, Gargi S. Sarode, Yashwant Ingale, Manjusha Ingale, Mahesh Chavan, Nilesh Patil, Barnali Majumdar, Prashant Kumar, Shankargouda Patil
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http://clinicsandpractice.org/index.php/cp/article/view/1040Tue, 13 Feb 2018 10:19:19 +0100Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropionhttp://clinicsandpractice.org/index.php/cp/article/view/1044
Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT. The symptoms that had motivated the admission gradually remitted and the patient was discharged home. Bupropion increases dopaminergic activity in both the nucleus accumbens and the prefrontal cortex. Therefore, from a physiopathological standpoint, bupropion has a potential role in treating NMS. However, there is scarce evidence supporting this approach and therefore future cases should be carefully considered.Quintí Foguet-Boreu, Montse Coll-Negre, Montse Serra-Millàs, Miquel Cavalleria-Verdaguer
Copyright (c) 2018 Quintí Foguet-Boreu, Montse Coll-Negre, Montse Serra-Millàs, Miquel Cavalleria-Verdaguer
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http://clinicsandpractice.org/index.php/cp/article/view/1044Fri, 26 Jan 2018 14:45:26 +0100Nephrotic syndrome in very elderly: Should we treat aggressively?http://clinicsandpractice.org/index.php/cp/article/view/1046
Chronic kidney disease and acute kidney injury are being increasingly recognized in very elderly patients, aged 80 or more. In cases of suspected glomerulonephritis with or without nephrotic syndrome, the clinical decision-making of whether to obtain a renal biopsy and treat with immunosuppressive therapy should not be based on advanced age alone but take into consideration the patient’s functional status and overall prognosis. Herein, we report a case of an elderly patient with minimal change disease who benefitted from a timely renal biopsy and aggressive immunosuppressive therapy.Abhilash Koratala, Jogiraju Tantravahi
Copyright (c) 2018 Abhilash Koratala, Jogiraju Tantravahi
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http://clinicsandpractice.org/index.php/cp/article/view/1046Wed, 24 Jan 2018 10:52:14 +0100Novel complication of an emerging disease: Invasive Klebsiella pneumoniae liver abscess syndrome as a cause of acute respiratory distress syndromehttp://clinicsandpractice.org/index.php/cp/article/view/1021
<em>Klebsiella pneumoniae</em> is an increasingly recognized cause of a unique invasive syndrome manifesting as pyogenic liver abscess and hematogenous extrahepatic dissemination to a variety of sites, including the lung. Originally described only in Asia, this entity has now been reported across continents and ethnicities. Intrathoracic complications of invasive <em>Klebsiella pneumoniae</em> liver abscess syndrome (IKPLAS) have been characterized sporadically but have not been the subject of an all-encompassing investigation. Review of the English-language literature yields no reports of the acute respiratory distress syndrome as a consequence of IKPLAS. Herein we report what, to our knowledge, is the first such description.Anupam Gupta, Saad Bhatti, Anatoly Leytin, Oleg Epelbaum
Copyright (c) 2018 Anupam Gupta, Saad Bhatti, Anatoly Leytin, Oleg Epelbaum
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http://clinicsandpractice.org/index.php/cp/article/view/1021Fri, 19 Jan 2018 09:08:31 +0100Peripheral giant cell granuloma recurring as an exclusively intra-osseous lesion: An unusual clinical presentationhttp://clinicsandpractice.org/index.php/cp/article/view/1023
Giant cell lesions of the jaws represent distinctive clinico-pathological spectrum. They manifest as peripheral and central lesions, occurring as solitary growths to involving multiple regions of the jaw. The present report presents a unique case of giant cell lesions of the jaws, wherein a peripheral giant cell granuloma recurred exclusively as a central giant cell lesion in a young patient. The recurrence was noted after a time-span of 3 years since the diagnosis and surgical excision of the peripheral lesion. Biochemical investigations were advised to rule out the possibility of hyperparathyroidism. Following a confirmed diagnosis of central giant cell granuloma, not associated with any other systemic conditions, an apt treatment plan was devised for an early rehabilitation of the patient.Kedar Vaidya, Gargi S. Sarode, Sachin C. Sarode, Barnali Majumdar, Shankargouda Patil
Copyright (c) 2018 Kedar Vaidya, Gargi S. Sarode, Sachin C. Sarode, Barnali Majumdar, Shankargouda Patil
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http://clinicsandpractice.org/index.php/cp/article/view/1023Mon, 08 Jan 2018 09:26:48 +0100Heterotaxy syndrome with intestinal malrotation, polysplenia and azygos continuityhttp://clinicsandpractice.org/index.php/cp/article/view/1004
Heterotaxy syndrome is a situs anomaly that comprises a large spectrum of cardiac and extracardiac malformations. Its association with intestinal malrotation is frequent. This later might be asymptomatic or manifest by signs of abdominal discomfort or of intestinal obstruction. We report on the case of a full term, small for gestational age neonate in whom heterotaxy syndrome with partial situs inversus abdominalis, intestinal malrotation, polysplenia and vena azygos continuity was diagnosed at prenatal echography. Due to the high risk of volvulus carried by the malrotation, Ladd’s procedure was performed at the age of two months. Follow-up examination at the age of four years shows excellent post-operative result and normal development of the child.Stéphanie Cupers, Christine Van Linthout, Brigitte Desprechins, Léon Rausin, Martine Demarche, Marie-Christine Seghaye
Copyright (c) 2018 Stéphanie Cupers, Christine Van Linthout, Brigitte Desprechins, Léon Rausin, Martine Demarche, Marie-Christine Seghaye
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http://clinicsandpractice.org/index.php/cp/article/view/1004Mon, 08 Jan 2018 09:26:50 +0100Primary hypoparathyroidism presenting as basal ganglia calcification secondary to extreme hypocalcemiahttp://clinicsandpractice.org/index.php/cp/article/view/1007
Hypoparathyroidism is a rare endocrine disorder characterized by low serum calcium and parathyroid hormone levels. The most common cause is parathyroid iatrogenic surgical removal. However, innumerous and rarer conditions can cause hypoparathyroidism. The authors describe a 27-year-old man that presented in emergency department with confusion, amnesia and decreased attention span. A cerebral computed tomography revealed bilateral extensive calcification in the basal ganglia. A complete work-up revealed low serum calcium, high serum phosphorus and low parathyroid hormone, leading to the diagnosis of idiopathic primary hypoparathyroidism. Initial intravenous therapy with calcium gluconate and calcitriol was administered, with clinical and analytical improvement. The authors describe a rare condition, with an exuberant cerebral presentation and extreme hypocalcemia, which did not directly correlate to the severity of symptoms. Not only this is a treatable disorder that may have catastrophic results if overlooked but also its symptoms may be completely reversed with prompt treatment.Edite Marques Mendes, Lúcia Meireles-Brandão, Carla Meira, Nuno Morais, Carlos Ribeiro, Diana Guerra
Copyright (c) 2018 Edite Marques Mendes, Lúcia Meireles-Brandão, Carla Meira, Nuno Morais, Carlos Ribeiro, Diana Guerra
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http://clinicsandpractice.org/index.php/cp/article/view/1007Mon, 08 Jan 2018 09:26:50 +0100Comparison of Cameriere’s and Demirjian’s methods of age estimation among children in Kerala: a pilot studyhttp://clinicsandpractice.org/index.php/cp/article/view/991
The aim was to compare age estimation using Cameriere’s and Demirjian’s methods to chronologic age in children with mixed dentition in a rural population of Kerala. The present study comprised of 10 subjects of age range 7-12 years. Dental age was assessed using Cameriere’s and Demirjian’s methods and was compared to the chronologic age. Panoramic radiographs were used for assessment of dental age. Data were analysed using paired t-test. The mean of difference obtained was 0.92 and the pvalue was 0.172 which showed insignificant difference between the two methods. Cameriere’s method showed a positive linear correlation (0.6393) with chronologic age and was statistically significant (P=0.0171) , whereas Demirjian’s method showed a negative correlation (–0.7598) and was statistically insignificant (P=0.9967). The present study indicated that Cameriere’s method is reliable for age estimation in our population and is more accurate than Demirjian’s method.Vivek Velayudhan Nair, Sunila Thomas, Jincy Thomas, Shabna Fathima, Deena Thomas, Tomson Thomas
Copyright (c) 2018 Vivek Velayudhan Nair, Sunila Thomas, Jincy Thomas, Shabna Fathima Salim, Deena Thomas, Tomson Thomas
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http://clinicsandpractice.org/index.php/cp/article/view/991Tue, 13 Feb 2018 10:55:42 +0100Studying the effects of primary arthroplasty on post-treatment results among elderly patients with pertrochanteric fracturehttp://clinicsandpractice.org/index.php/cp/article/view/1055
Various therapeutic methods are available to treat patients with intertrochantric fracture, which is usually caused by falling down. This complication is usually observed among the elderly, particularly old women. The choice of the proper therapeutic method depends on many factors including patient’s condition, type of fracture, and the amount of movement. Hip arthroplasty is one of these therapeutic methods, which have certain advantages and disadvantages. Immediate resumption of walking with the ability of weight toleration and absence of complications such as aseptic necrosis are some advantages of this method. Sixtyeight elderly patients with pertrochanteric fracture who had resorted to Iranian Army’s hospitals and had undergone arthroplasty. These cases were examined with due comparison with historical and external controls. Variables such a type of operation, age, post-operation pain, the pace of resuming walking ability, embolism, surgical site infection, bedsore and DVT were studied and compared against standard operation. The results achieved through assessment of variables showed a significant difference with standard operation in terms of variables such as post-operative movement ability, pain scale in various times, surgical complications, embolism, surgical site infection, bedsore, and DVT. Post-operative pain within the first 3 months following it are some complications with not much attention is paid to them, but they are important complications which can cause many negative and influential effects on patients. Arthroplasty is more expensive than standard operation and the patient may initially feel more pain.Mostafa Shahrezaee, Mohammad Ali Okhovatpour, Mohammad Banasiri, Seyyed Reza Sharifzadeh
Copyright (c) 2018 Mostafa Shahrezaee, Mohammad Ali Okhovatpour, Mohammad Banasiri, Seyyed Reza Sharifzadeh
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http://clinicsandpractice.org/index.php/cp/article/view/1055Fri, 26 Jan 2018 12:39:34 +0100Determining the role of intravenous hydration on hospital readmissions for acute congestive heart failurehttp://clinicsandpractice.org/index.php/cp/article/view/981
The role of intravenous hydration on hospital readmissions due to acute exacerbation of congestive heart failure (CHF) has not been studied sufficiently to the best of our knowledge. We sought to determine the possible role of intravenous hydration on hospital readmissions for acute CHF and fluid overload and explain how an intravenous fluid (IVF) restriction strategy may help reduce hospital readmission rates. We retrospectively studied the electronic medical records of 98-patient cohort who had hospital readmission due to acute decompensated congestive heart failure (ADHF) during the period of January 1, 2016 to July 9, 2016. These patients were admitted with reasons other than ADHF during the index admission. The patients were divided into two groups; those with ADHF readmissions within 15 days of index admission (group A) and those after 15 days (group B). Various factors affecting CHF readmissions as outlined in the results were compared between these two groups. Cohort of 98 patients (53 females, 54.1%; 76.4±11.6 years) re-admitted during the study period of 1/1/2016 to 7/9/2016 were analyzed. 71 patients had only received IVF during index admission. These were subdivided into group A (12 females, 54.5 %; mean age 75.9±12.9 years) and group B (25 females, 51.02%; mean age 76.08±11.90 years) based on readmission ≤15 days or &gt;15 days from the index admission. There was no statistically significant difference (P=0.97) in amount of IVF prescribed between two subgroups but the duration of prescribed IVF significantly affected readmission in group A compared to group B (P=0.03). While the drop in albumin and rise in creatinine were not significant, the mean hemoglobin (Hb) drop in group A compared to group B was significant at P=0.008. Type of IVF and nature of CHF (heart failure with reduced ejection fraction, HFrEF/heart failure with preserved ejection fraction, HFpEF) were not found to significantly affect early readmissions associated with IV hydration. In patients with history of CHF, duration of IVF prescribed during the index admission seems to play important role in early CHF readmission (defined as &lt;15 days in our study).Munish Sharma, Ravi Kumar Patel, Mahesh Krishnamurthy, Richard Snyder
Copyright (c) 2018 Munish Sharma, Ravi Kumar Patel, Mahesh Krishnamurthy, Richard Snyder
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http://clinicsandpractice.org/index.php/cp/article/view/981Mon, 08 Jan 2018 09:26:50 +0100Variables affecting factors associated with primary headachehttp://clinicsandpractice.org/index.php/cp/article/view/1031
Primary headache syndromes’ development is associated with biological, psychological and social parameters. Factors such as daily habits, behavioral characteristics and sleep disorders also play an important role. We aim to identify the variables which affect the above factors. The study included 111 patients affected by primary headache. The patients were stratified into subgroups according to gender, age, occupation and headache type. Women attained higher scores than men in three of the evaluation rating scales and lower scores in the severity of dependence scale. Occupation was associated with SF36 and Hamilton anxiety scale. Unemployed had higher scores in Hamilton anxiety. Migraineurs and occupied individuals have lower SF36 scores. Women are associated with depression, anxiety and higher disability derived from headache. Men are more prone to dependence on opioids. Unemployment was linked with anxiety and well-being. The migraneurs presented a decreased level of quality of life.Athanasia Alexoudi, Konstadinos Politis, Anthi Moukidou, Rebekka Tsatovidou, Sarantoula Ververaki, Antonios Tavernarakis, Anna Siatouni, Anastasia Verentzioti, Dimos Mitsikostas, Stylianos Gatzonis
Copyright (c) 2018 Athanasia Alexoudi, Konstadinos Politis, Anthi Moukidou, Rebekka Tsatovidou, Sarantoula Ververaki, Antonios Tavernarakis, Anna Siatouni, Anastasia Verentzioti, Dimos Mitsikostas, Stylianos Gatzonis
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http://clinicsandpractice.org/index.php/cp/article/view/1031Mon, 08 Jan 2018 09:26:51 +0100